Pills and HMP

Not everyone agrees with the prison psychiatrist's methods when it comes to inmates' medication

James McLeod jmcleod@thetelegram.com
Published on August 22, 2009
HMP inmate Gordon Bishop, 25, of St. John's says he doesn't agree with the prison doctor's decision to reduce inmates' prescriptions. -Photo by Joe Gibbons/The Telegram

At one point four years ago, when he was "fit to stand trial," Gordon Bishop was on 15 different medications - 22 pills a day.

He had been diagnosed with manic depression and attention-deficit/hyperactivity disorder.

Despite being on trial for assault, resisting arrest and dangerous operation of a motor vehicle - which he was eventually found guilty of - Bishop says "everything was going good in my life for that brief period of time."

At one point four years ago, when he was "fit to stand trial," Gordon Bishop was on 15 different medications - 22 pills a day.

He had been diagnosed with manic depression and attention-deficit/hyperactivity disorder.

Despite being on trial for assault, resisting arrest and dangerous operation of a motor vehicle - which he was eventually found guilty of - Bishop says "everything was going good in my life for that brief period of time."

After the trial, when he arrived at Her Majesty's Penitentiary (HMP), he says, within a week the prison's psychiatrist took him off all the pills and left him to fend for himself.

"Ever since then, I've been in and out of here," Bishop said of HMP.

Bishop is currently in prison on remand, facing assault-with-a-weapon charges stemming from an incident where a police officer was sprayed with bear spray.

The longest period Bishop has spent out of jail since he was 12 years old was an eight-month stretch.

"I get and I got that much anxiety, that much stress and that much frustration, and that much coming at me at the same time, I get myself in trouble," Bishop said.

Without access to prescription medication, he said, he self-medicates, using Valium when he's up, and cocaine when he's down to try to even himself out. This, he fully admits, is an expensive, unpredictable and dangerous strategy.

Several inmates and their families contend that the psychiatric service at HMP is part of the problem, not the solution.

The doctor

Within the justice system, Dr. David Craig is a well-known figure. During a comprehensive review of the province's prisons conducted last year, nearly half of the inmates interviewed brought up his treatment methods.

"Dr. Craig is known for his conservative approach to prescribing medications, and soon after he began work at the prisons, he started cutting back on prescribed medications to inmates," the review stated.

"He felt that some medications were inappropriate as he observed that most inmates had substance-use disorders and/or personality disorders and were not otherwise mentally ill."

Paula Squires, whose son Douglas is currently on remand in HMP, charged with break and enter, puts it another way. She said Craig acts like prisoners are "pulling the wool over your eyes" to get medication.

Bishop agrees.

"He thinks if you're in jail, you're punished; you abuse your drugs, you abuse your medication," Bishop says of Craig. "He wants you to feel every bit of punishment you can while you're in here."

According to an estimate by Craig, if you include substance abuse and antisocial personality disorders, about 90 per cent of inmates have mental health issues.

Craig has refused multiple interview requests by The Telegram.

Justice Minister Tom Marshall also refused to do an interview for this story, but sent an e-mail statement to The Telegram.

"As a result of the independent review, Budget 2009 placed an additional $6 million into adult corrections, including providing psychological services to all facilities and a psychologist and addictions co-ordinator for Her Majesty's Penitentiary to join the psychiatrist, medical doctor and nurse practitioner at the facility," Marshall wrote.

"If an inmate has a concern with the medical practitioners at Her Majesty's Penitentiary they should contact the College of Physicians and Surgeons of Newfoundland and Labrador."

Twenty complaints have been filed against Craig with the college, but none led to disciplinary action.

The Waterford

At the Waterford Hospital in St. John's, Dr. Nizar Ladha's methods are starkly opposite to Craig's.

Ladha works in the forensic psychiatry unit of the Waterford and is typically the physician who prescribes medication and deems people fit to stand trial.

He said a person who can't function because of mental illness is no different from someone who can't function due to another health problem. In both cases, he says, after appropriate treatment - involving medication - has been administered, a person can go back to functioning normally.

He dismisses the argument that people with addictions should be denied medications because they might be faking symptoms.

"Say a person has cardiac disease and they don't exercise, and their diet is not adequate, and just to complicate a little bit, the person smokes," he says.

"He's advised to exercise, lose weight, quit smoking. The person does none of the above, and six months later or 18 months later comes back with another cardiac problem. Are we going to run that person out, are we going to say, 'We're not going to treat you?'"

Strategy needed

Of the 77 recommendations in the prison review, 10 specifically address mental health services.

Noting that "not all professionals agree with Dr. Craig's approach," the review recommended that "a comprehensive strategy be developed to address the mental health issues of offenders so that the qualify of care and support is based on professionally accepted standards."

Officials with the Justice Department couldn't point to any specific strategy being drawn up, but said the psychological services and addictions co-ordinator that the justice minister mentioned in his statement might be part of that.

Bishop offers a different solution.

"They should have fired (Craig) long ago."

jmcleod@thetelegram.com